2.Comparative analysis of clinical characteristics and prognosis of children with necrotizing pneumonia infected by bacteria and Mycoplasma pneumoniae
Qi ZHANG ; Yinan XING ; Lei SHEN ; Lin ZHU
Chinese Journal of Postgraduates of Medicine 2021;44(3):230-234
Objective:To compare the clinical characteristics and prognosis of children with necrotizing pneumonia (NP) infected by bacteria and Mycoplasma pneumoniae (MP). Methods:The clinical data of 69 children with NP from January 2012 to June 2019 in Dalian Central Hospital Affiliated to Dalian Medical University were retrospectively analyzed. Among them, there were 27 cases of bacterial infection NP (bacterial infection group) and 42 cases of MP infection NP (MP group). The clinical symptoms and signs, extrapulmonary complications, laboratory examination, imaging examination, treatment, outcome and follow-up were compared between 2 groups.Results:There were no significant differences in the rale rate, respiratory tone reduction rate and total fever time between 2 groups ( P>0.05); the incidence of shortness of breath in bacterial infection group was significantly higher than that in MP group: 77.8% (21/27) vs. 14.3% (6/42), and there was statistical difference ( P<0.01). There were no significant differences in the incidence of extrapulmonary complications between 2 groups ( P>0.05). The white blood cell, C-reactive protein (CRP), procalcitonin (PCT) and interleukin (IL) -10 in bacterial infection group were significantly higher than those in MP group, the tumor necrosis factor (TNF)-α and interferon (IFN) -γ in bacterial infection group were significantly lower than those in the MP group, and there were statistical differences ( P<0.05). There were no significant differences in neutrophils, lactate dehydrogenase (LDH) and IL-6 between 2 groups ( P>0.05). The time of necrosis in bacterial infection group was significantly earlier than that in MP group: (14.5 ± 4.2) d vs. (21.7 ± 6.4) d, and there was statistical difference ( P<0.05); there was no significant difference in the incidence of pleural effusion between 2 groups ( P>0.05), but the incidence of pleural effusion separation in bacterial infection group was significantly higher than that in MP group: 70.4% (19/27) vs. 2.4% (1/42), and there was statistical difference ( P<0.01). There were no significant differences in antibiotic application time, CRP recovery time and hospital stay between 2 groups ( P>0.05); the oxygen uptake rate and closed thoracic drainage rate in bacterial infection group were significantly higher than those in MP group: 88.9% (24/27) vs. 35.7% (15/42) and 25.9% (7/27) vs. 11.9% (5/42), the recovery times of WBC and PCT in bacterial infection group were significantly longer than that in MP group: (12.8 ± 4.1) d vs. (9.2 ± 2.0) d and (10.5 ± 2.5) d vs. (7.6 ± 1.9) d, the bronchoalveolar lavage rate was significantly higher than that in MP group: 25.9% (7/27) vs. 76.2% (32/42), and there were statistical differences ( P<0.01 or <0.05). There was no significant difference in the absorption time of necrotic lesions between 2 groups ( P>0.05). Conclusions:Compared with MP infection, the clinical process of bacterial infection NP is serious, the necrosis time appears earlier, and the course of disease is longer. However, most of the children with NP can obtain a good prognosis after active symptomatic and antiinfective treatment.
3.A study on the possibility of using circulating microRNAs as biomarkers for the diagnosis of tubercu- losis
Shuaili CAO ; Aiping SHEN ; Qingfeng ZHU ; Qing YANG ; Xudong CAO ; Jianxin XING ; Hong WANG ; Li YUAN
Chinese Journal of Microbiology and Immunology 2014;(10):787-792
Objective To evaluate the possibilities of using circulating miR-155-5p, miR-21-5p, miR-29a and miR-142-5p as biomarkers for the diagnosis of active pulmonary tuberculosis (TB).Methods Plasma samples were collected from 60 healthy subjects, 40 patients with active pulmonary TB and 20 sub-jects with latent tuberculosis infection ( LTBI) to extract miRNAs.The levels of miR-155-5p, miR-21-5p, miR-29a and miR-142-5p in plasma samples were detected by using reverse transcription-quantitative PCR. Results The levels of miR-155-5p, miR-21-5p and miR-29a in patients with active pulmonary TB were re-spectively 10.13, 7.34 and 2.74 times as much as those in healthy subjects(P<0.05).No significant differences with the level of miR-142-5p were observed between the two groups.The receiver operating char-acteristic (ROC) curve analysis of miR-155-5p, miR-21-5p and miR-29a in patients with active pulmonary TB and healthy subjects showed that the areas under the curve (AUC) were respectively 0.905, 0.830 and 0.687.The level of miR-155-5p in patients with LTBI was 3.1 times than that in healthy subjects ( P<0. 05).No differences with miR-21-5p, miR-29a and miR-142-5p were found between patients with LTBI and healthy subjects.The levels of miR-155-5p, miR-21-5p and miR-29a in patients with active pulmonary TB were respectively 3.26, 6.69 and 1.98 times than those in patients with LTBI (P<0.05).The rate of LTBI was 40.58%in people who were in close contact with patients with active pulmonary TB.Conclusion Sig-nificant differences with the levels of miR-155-5p, miR-21-5p and miR-29a were observed among healthy subjects, patients with active pulmonary TB and patients with LTBI, but no difference with the level of miR-142-5p was observed among them.miR-155-5p, miR-21-5p and miR-29a could be used as the potential bio-markers for the diagnosis of active pulmonary tuberculosis and latent tuberculosis infection.People who were in close contact with patients with active pulmonary TB could have a higher LTBI rate.
4.Effects of mesenchymal stem cell transplantatiOn on cardiac function and structure and eIectrophysiology in rabbits with dilated cardiomyopathy
Gengsheng YU ; Xing SHEN ; Jie TIAN ; Yonghong BAI ; Jing ZHU ; Guanxin LIU ; Yuan CHEN
Chinese Journal of Tissue Engineering Research 2008;12(34):6776-6780
BACKGROUND: The study of cell transplantation to repair injured cardiac muscle and improve cardiac function of dilated cardiomyopathy (DCM) has become a hotspot in recent years. However, the effect of cardiac electrophysiology following transplantation is still unknown.OBJECTIVE: To explore the influence of ailogenic implanted mesenchymal stem cells (MSCs) on cardiac function, structure and electrophysiology of rabbits with DCM.DESIGN, TIME AND SETTING: Randomized controlled animal trial was performed at Electrophysiology Laboratory of Institute of Pediatrics, Chongqing Medical University between January 2004 and May 2006.MATERIALS: Forty-three New Zealand whiterabbits, weighing 3.0-3.5 kg, irrespective of gender, were selected. Adriamycin was produced by Haizheng Medical Products Company of Zhejiang Province, China, No. 050307. The Ultrasonograph SSD-5000 came from Aloka, Japan, and RM6240 multiplying channel electrophysiolograph of Chengdu Instrument Company was applied.METHODS: All animals were randomized into normal group (n=12), cell transplantation group (n=13), and DCM model group (n=13). Except the normal group, adriamycin was applied to create rabbit DCM model, I mg/kg, twice a week for successive 8 weeks. Bone marrow solution was harvested from the remaining 5 rabbits, and MSCs were isolated, amplified and purified using attachment method. Three weeks after modeling, the MSCs were transplanted into left ventricle anterior wall at four sites in cell transplantation group, model group was injected with matching DMEM/FI2 medium, while the normal group was not given any treatment.MAIN OUTCOME MEASURES: At four weeks postoperatively, left ventricular end-diastolic dimension, end systolic dimension,left ventricular ejection fraction, and shortening fraction were monitored by ultrasonograph; the value for monophasic action potential amplitude (MAPA) and the maximum velocity in 0 phase (V,,~), the value for 50% monophasic action potential durations (MAPDs0) and 90% monophasic action potential durations (MAPDg0) were detected by electrophysiolograph. In addition, the cardiac tissues harvested from implanted region were observed by light microscope and electron microscope, and also the expression of cardiac troponin T (cTnT) and connexin 43 (Cx43) was detected through immunohistochemistry.RESULTS: Of 43 rabbits, 9 rabbits each of the transplantation group died of the acute or chronic toxic effects of Adriamycin, finally, 25 rabbits were included in final analysis. Compared with model group, the end systolic dimension was diminished, and the left ventricular ejection fraction and shortening fraction in cell transplantation group were significantly increased (P < 0.05). The MAPDs0 and MAPDgo in cell transplantation group prolonged significantly compared with model group (P < 0.05). In model group,cardiac myocytes appeared mitochondria swelling and hyperplasia, and their sarcomere had different lengths, arranged unevenly,accompanied by abnormal contraction bands. In addition, myolysis was found in parts of myocardium under electron microscope.However, the structural abnormalities in the cell implantation group were less than the DCM model group, and the implanted MSCs could express cTnT and Cx43.CONCLUSION: Allogenic MSCs transplantation can improve cardiac function, lessen structural abnormalities and may inhibit the progression of electrophysiology derangement.
5.Effects of nuclear factor-kappaB on ventilator induced lung biotrauma by higher tidal volume and its interaction with pro-inflammatory cytokines.
Jian-xing ZHU ; Li-juan XIE ; Xiao-dong ZHU ; Yi SHEN ; Fei CHEN ; Xiao-ming SHEN
Chinese Journal of Pediatrics 2006;44(4):299-303
OBJECTIVESTo investigate the changes of nuclear factor (NF)-kappaB activation in lung tissues and expression of cytokines in homogenate from lung tissues in infant rabbits with mechanical ventilation (MV) caused lung injury.
METHODSForty-five general grade healthy infant rabbits were randomly divided into 3 groups: (1) CONTROL: with no MV (NMV, n = 9); (2): Conventional MV (CMV, n = 9): V(T) = 8 ml/kg; (3): MV with large tidal volume (V(T)) (LMV, n = 9), V(T) = 24 ml/kg. NF-kappaB activity in nuclear protein from lung tissues was measured with electrophoretic mobility shift assay (EMSA); quantity of IkappaBalpha in cellular plasma from lung tissues was analyzed with Western blotting method; TNF-alpha and IL-8 mRNA and their concentrations in homogenate were measured from lung tissues with RT-PCR and ELISA, respectively.
RESULTSAt all time points NF-kappaB activity was higher in LMV than that in CMV and NMV groups (P < 0.01). Quantity of IkappaBalpha decreased progressively in LMV with time (P < 0.01) as compared to CMV and NMV. The expressions of TNF-alpha and IL-8 and their protein quantity in lung tissues significantly increased in LMV after ventilation compared to that in CMV and NMV (P < 0.01). The expression level of TNF-alpha reached its peak at 4 hrs and IL-8 at 6 hrs after ventilation then TNF-alpha decreased significantly at 6 hrs after ventilation. Pathological examination of the lung tissues showed that as MV extended over the time in LMV, alveolar structures were severely destroyed and large number of WBC infiltrated in both alveolar sacs and pulmonary interstitia with RBC leakage. However, there was less lung injury in CMV and no obvious injury in NMV.
CONCLUSIONSIkappaBalpha degradation and NF-kappaB activation were involved in modulating the expression of pro-inflammatory cytokines in lung tissues during the occurrence of lung injury caused by injuring MV.
Animals ; Animals, Newborn ; Blotting, Western ; Disease Models, Animal ; Electrophoretic Mobility Shift Assay ; Enzyme-Linked Immunosorbent Assay ; Interleukin-8 ; genetics ; metabolism ; Lung ; metabolism ; NF-kappa B ; metabolism ; RNA, Messenger ; metabolism ; Rabbits ; Random Allocation ; Reverse Transcriptase Polymerase Chain Reaction ; Tidal Volume ; Tumor Necrosis Factor-alpha ; genetics ; metabolism ; Ventilator-Induced Lung Injury ; metabolism
6.Clinicopathological and related gene analysis in gastric adenocarcinoma and their correlation with prognosis
Xing-Hao NI ; Chuan-Ding YU ; Shen-Hua XU ; Xing-Ming ZHOU ; Yu-Tiang LIN ; Gu ZHANG ; Chi-Hong ZHU ; Xiang-Lin LIU ;
Cancer Research and Clinic 2006;0(10):-
Scm in volume(42/60),multiple site involvement(44/60),blood type"O"(31/41),in comparison with those of survival group,and the difference was statistically significant.C-erbB-2,p16,p53,P-gp,CD_(44) and CD_(25)expression were not significantly different in these two groups. Conclusion The clinical stage, lymph node metastasis,lymphatic tumor emboli and/or neural involvement,infiltration depth,histological dif- ferentiation,tumor volume,involvement extension are important prognostic factors in patients with gastric can- cer,while the significance of cancer-related gene expression in gastric carcinomas needs to be studied further.
7.The role of inflammatory stress in acute coronary syndrome.
Cheng-xing SHEN ; Hao-zhu CHEN ; Jun-bo GE
Chinese Medical Journal 2004;117(1):133-139
OBJECTIVETo summarize current understanding of the roles of anti-inflammatory and proinflammatory mechanisms in the development of atherosclerosis and acute coronary syndrome and to postulate the novel concept of inflammation stress as the most important factor triggering acute coronary syndrome. Moreover, markers of inflammation stress and ways to block involved pathways are elucidated.
DATA SOURCESA literature search (MEDLINE 1997 to 2002) was performed using the key words "inflammation and cardiovascular disease". Relevant book chapters were also reviewed.
STUDY SELECTIONWell-controlled, prospective landmark studies and review articles on inflammation and acute coronary syndrome were selected.
DATA EXTRACTIONData and conclusions from the selected articles providing solid evidence to elucidate the mechanisms of inflammation and acute coronary syndrome were extracted and interpreted in the light of our own clinical and basic research.
DATA SYNTHESISInflammation is closely linked to atherosclerosis and acute coronary syndrome. Chronic and long-lasting inflammation stress, present both systemically or in the vascular walls, can trigger acute coronary syndrome.
CONCLUSIONSInflammation stress plays an important role in the process of acute coronary syndrome. Drugs which can modulate the balance of pro- and anti-inflammatory processes and attenuate inflammation stress, such as angiotensin-converting enzyme (ACE) inhibitors/angiotensin II receptor blockers, statins, and cytokine antagonists may play active roles in the prevention and treatment of acute coronary syndrome when used in addition to conventional therapies (glycoprotein IIb/IIIa receptor antagonists, mechanical intervention strategies, etc).
Angina Pectoris ; etiology ; Arteriosclerosis ; etiology ; Biomarkers ; blood ; Blood Vessels ; physiopathology ; Humans ; Inflammation ; complications ; drug therapy ; physiopathology ; Myocardial Infarction ; etiology ; Stress, Physiological ; complications ; Syndrome
8.Mechanism of hepatocytes transdifferentiation to bile duct epithelial cells and intervention of huangqi decoction.
Bing-Feng QIU ; Jin-Xing DU ; Ding-Zhu SHEN
Chinese Journal of Integrated Traditional and Western Medicine 2010;30(5):513-518
OBJECTIVETo investigate the mechanism of hepatocytes transdifferentiation to bile duct epithelial cells (BECs) and intervention of Huangqi decoction (HQD) on hepatic fibrosis formation in rats with secondary cholestasis.
METHODSSeventy-five SD male rats were made into cholestatic hepatic fibrosis model animals by bile duct ligation, and randomized into the control group (n = 50) and the HQD group (n = 15). Starting from one week after modeling, they were administered orally with saline and HQD respectively for four weeks. Besides, a sham-operated group was set up with 10 rats operated by choledochus segregating only and administered after then with saline. Rats were killed in batches at different time points, i.e. each five from the control group and sham-operated group at the end of the 1st week, five from the control group for each time at the end of the 2nd, 3rd and 4th week, and all the remaining rats at the end of the 5th week. Their liver tissues were taken for histological change examination, content of hydroxyproline (Hyp) determination; protein expression of BECs marker cytokeratin 7 (CK7) and the hepatocyte specific antigen HepPar detection by Western blot, and CK7-Hep Par co-localization by laser confocal microscopy. Then IPP software was used to analyze Sirius red stained positive areas of CK7 and Hep Par, as well as the average IOD of CK7/Hep Par co-localization.
RESULTSHepatocytes in hepatic tissues (Hep Par positive cell) in the model rats decreased gradually along was time went by after modeling (Sham > M1w > M2w > M3w > M4w > M5w), which was in parallel with the increase of BECs (CK7 positive cells), degree of fibrosis, Hyp content and CK7 protein expression. Increasing of co-localized positive cells of CK7/Hep Par began at 1 week and reached the peak 3 weeks after modeling, then it decreased gradually. The Hep Par protein expression was negatively correlated with that of CK7; the Hep Par positive cell expression was negatively correlated with CK7 positive cell expression and collagen deposition; while the CK7 positive cell expression was positively correlated with the collagen deposition in the liver tissue. Compared with the model control group, the mortality, CK7/Hep Par co-localized positive cells, fibrosis degree, Hyp content and CK7 protein expression were lesser obviously (P < 0.01), while Hep Par positive cell and protein expressions were higher significantly in the HQD group.
CONCLUSIONSHepatocytes transdifferentiation to BECs might be a key pathological element for secondary cholestatic hepatic fibrosis formation; the restraining action of HQD is possibly a major action mechanism of HQD for effectively intervening and treating secondary cholestasis hepatic fibrosis.
Animals ; Astragalus Plant ; Bile Ducts ; cytology ; Cell Transdifferentiation ; drug effects ; Drugs, Chinese Herbal ; pharmacology ; Epithelial Cells ; cytology ; drug effects ; Hepatocytes ; cytology ; drug effects ; Liver ; Liver Cirrhosis, Biliary ; drug therapy ; pathology ; Male ; Phytotherapy ; Rats ; Rats, Sprague-Dawley
9.Effects of TCE and PCE on cultured human keratinocyte lipid peroxidation and protective effect of vitamin E on it.
Rui DING ; Tong SHEN ; Qi-Xing ZHU
Chinese Journal of Industrial Hygiene and Occupational Diseases 2006;24(11):662-665
OBJECTIVETo explore the different concentrations of trichloroethylene (TCE) or perchloroethylene (PCE) induced cultured normal human epidermal keratinocyte (KC) lipid peroxidation and protective effect of Vitamin E on it.
METHODSKC derived from 3 or more donors were pooled together and cultured with K-SFM. Neutral Red Uptake Assay was used to determine the IC50 of TCE or PCE, and then different concentrations of TCE or PCE were administered for culturing KC; 0.5 mmol/L TCE or 0.2 mmol/L PCE and different concentrations of Vitamin E were used to determine the protective effect of Vitamin E. After 4 hours' culture, kits were used to determine cellular MDA, SOD and ROS level.
RESULTSTreatment of KC with different concentrations of TCE or PCE showed significant dose-related variations in lipid peroxidation, with the higher concentration, higher level of MDA, ROS and lower activity of SOD displayed in this study. Vitamin E 10 - 200 mmol/L dose-dependently attenuated MDA and ROS level, and increased SOD activities.
CONCLUSIONTCE or PCE can induce the lipid peroxidation in cultured KC and Vitamin E protects it from TCE- or PCE-induced peroxidation.
Antioxidants ; pharmacology ; Cells, Cultured ; Dose-Response Relationship, Drug ; Humans ; Keratinocytes ; drug effects ; metabolism ; Lipid Peroxidation ; drug effects ; Malondialdehyde ; metabolism ; Reactive Oxygen Species ; metabolism ; Superoxide Dismutase ; metabolism ; Tetrachloroethylene ; toxicity ; Trichloroethylene ; toxicity ; Vitamin E ; pharmacology
10.The value of liver biopsy for pathological diagnosis in liver transplant patients
Yanqing WANG ; Qiang XIA ; Jianjun ZHANG ; Jianshan ZHU ; Xiaosong CHEN ; Ming ZHANG ; Yi LUO ; Conghuan SHEN ; Tianyu XING
Chinese Journal of General Surgery 2000;0(11):-
Objective To evaluate liver biopsy for the diagnosis in liver transplant patients with suspected acute rejection. Methods From Oct. 2004 to Apr. 2005, liver biopsies were performed 53 times in 39 transplant cases. Results Based on Banff schema for grading liver allograft rejection, laboratory abnormalities and result of treatment, acute rejection was diagnosed on 16 episodes, preservation injury in 12, bile duct strictures in 9, drug-induced injury in 11, chronic rejection in 3 and acute hepatic failure in 2. Conclusions Hepatocyte ballooning with necrosis features preservation injury. Drug-induced injury commonly has a combination of hepatocyte denaturalization with mild portal inflammation. Histologic features of early bile duct strictures in liver biopsy show prominent bile ductular proliferation and the canalicular cholestasis with mild hepatocyte damage which help to exclude acute rejection.